a medical librarian's adventures in evidence-based living

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Heart Disease

July 07, 2012

"Most of my career I looked at coronary artery disease as a "terminal disease". You'd die from it. But, I began seeing more research showing that not only was it preventable, but it was reversible.

I heard Dr. Caldwell Esselstyn, Jr. speak at meeting three years ago--and it opened my eyes.

I started studying & doing my own research on others who were doing similar research. Esselstyn wasn't alone. There's a building body of evidence that coronary artery disease is preventable & reversible. That was eye-opening."

Hands down, via Facebook, email, & blog comments--this was the post most of you wanted to read first:

Two cardiologists and one cardiovascular surgeon who decided to follow Esselstyn's plant-based no-oil diet.

What's their story, why did they decide to take this route for themselves, and how has it benefited their health?

Since starting Happy Healthy Long Life over four years ago I've heard from a number of physicians who have shared their personal success stories following an Esselstyn-style plant-based diet. They represent a wide range of specialties.

The stories all share similar elements. And the physicians are all surprised (some even shocked) & pleased by the non-pharmaceutical results:

Everyone's surprised at how much easier the diet is to follow than they expected.

Their food tastes & preferences changed.

But, let's face it. A plant-based, no-added oil diet is far from mainstream, or standard medical practice. Many physicians aren't ready to "go public" about how well this is working for them, or for their patients who have hopped onboard.

To me it speaks volumes, when a cardiologist, in particular, chooses to adopt a plant-based diet. And, of course, I want to know why. I figured you would, too.

That's why I decided to share the experiences of two cardiologists & one cardiac surgeon.

Cardiologist Number One

When I was preparing my "Centenarian Strategies" presentation back in March, I asked a cardiologist who had written me, if he would be willing to share his "back story"--why he made the personal switch to a plant-based diet.

I thought it would be a compelling story to share. Everyone who has seen my presentation--and heard his story, thought so, too. I can't thank him enough for taking the time to put it into words.

Here's what he wrote:

Almost 3 years ago, as a 40-year-old cardiologist with a family history of heart disease, I looked at my body as a painful example of what happens when a person spends too much time working, eats badly, and never exercises. I was not very overweight, but I have high standards for myself and I felt that I was weak and quite flabby, and I knew that there was unseen damage on the inside of me.

Even more importantly, I just didn’t feel good.

Back in 1994 I had the good fortune to eat dinner with Dr. Esselstyn at a restaurant in Philadelphia and after the meal was over, he told me that by eating what I had ordered (fish) that I had subjected my body to “a hit from which it would never recover.” Those words stuck with me, and 15 years later, when I heard him lecture I found myself really wondering what it would be like to eat the way he does.

My lipids fell by nearly half after only 3 weeks! My body fat percentage went from 19% to 15% within a year and I slowly lost 25 pounds over about 18 months before stabilizing at my current weight.

I was never hungry and I felt physically so much better, with so much more energy. I eventually quit caffeine too, which was not easy, but afterward felt great without it. Most importantly, I really felt in control of my health and my body, and this was the true cure for my mid-life crisis of a body going downhill.

All of this was without exercising. I later began exercising regularly, which added additional benefits, including further lowering of my body fat to 11% and gain of muscle and flexibility. I feel like I am more than 10 years younger now. My blood pressure has gone from 130/90 to 110/65 and my resting heart rate from 80 to 55.

Since I made these changes, I have made it a point not to preach to others about its benefits. I eat what I eat without compromising, but don’t make a big deal about it to others. I have never tried to convince anyone else to eat the way that I eat, but many people are interested and I have always answered every question asked of me carefully and completely.

In just a couple of years, almost 20 friends and family members have gone on to convert to the Esselstyn diet – it’s contagious! As a cardiologist, I know that, for people eating a typical American diet, the chance over a lifetime of severe illness or death due to food-related diseases is staggering. My greatest reward is knowing that my own choices have inspired others to make such wonderful changes in their own lives.

Cardiologist Number Two

I "met" this cardiologist about a year ago.

In his practice he had some patients who were unable to tolerate statins because of their side effects, and others who were just unwilling to take them.

They needed viable alternatives.

When he heard Dr. Caldwell Esselstyn's lecture he was impressed with both the research, and Dr. Esselstyn's results. Maybe this was the alternative he was looking for. But, before advising any of his patients to give a plant-based no-added-oil diet a try, he wanted to try it out for himself first.

The widely accepted belief by cardiologists is that "Eighty percent of the body’s cholesterol is made by the liver. That means, only 20 percent comes from our diet. That’s why it is so hard to lower cholesterol through diet alone. By banning nearly all cholesterol from your diet, you might be able to reduce your total cholesterol level by about 20 percent. Understanding this can often make the choice to take cholesterol-lowering drugs easier."

However, here's what cardiologist #2 experienced for himself on a plant-based diet:

He personally cut his total cholesterol from 209 to 136 and his LDL's from 144 to 72 with just nutritional changes. That's a 50% drop in LDL's. A lot better than the conventional wisdom would have you believe.

His interpretaton of the conventional cardiology wisdom that says "Diet can't cut cholesterol or inflammation significantly.":

I think it is fallacious to say that because 20% of your [cholesterol] intake is dietary, you cannot reduce [your cholesterol] by more than 20% by changing your diet.

This part is just plain wrong.

The statement that 80% of your cholesterol is made by the body and only 20% comes from diet is based on the average (as measured in the population eating the Western diet) cholesterol production of 1 gm per day and the recommended dietary intake of cholesterol of 200-300 mg.

For many Americans, the daily intake of cholesterol is much higher. For those eating a plant-based diet, the intake is near zero. So the 20% is not representive of a population, but rather an average of very different nutritional choices. Several other logistical fallacies occur to me:

Population studies on humans who eat a plant-based diet with very low dietary cholesterol intake show some of the lowest intrinsic cholesterol levels. We have many studies on dietary modification showing that decreasing cholesterol intake can result in dramatic lowering of serum cholesterol levels.

Relatively few (if any) studies of cholesterol regulation have been performed in vegans, so we don't have much information on the effect of this nutritional strategy on cholesterol synthesis. You can't extrapolate findings from studies of patients on a Western diet.

The assertion that drug therapy of elevated cholesterol is more effective than nutritional changes focuses on a surrogate endpoint, that is, the cholesterol level, rather than clinically important endpoints like death, MI and stroke.Dependence on surrogate endpoints (cholesterol levels) is a one of the biggest criticisms of drug and device studies. Statins have been shown to result in improvement in early MI and death rates, but they are not above suspicion for longer term adverse outcomes and there is a growing concern about the downside of life long administration. Several drugs have been removed from the market because they lead to higher death rates despite their beneficial effect on surrogate endpoints. We need to look at the the MI, death and stroke rates of nutritional changes, not whether they can decrease cholesterol by 20%.

That said, there is no question that statins have a role in the early treatment of unstable coronary disease, but it is likely not due to their cholesterol-lowering effect, but rather on their anti-inflammatory and pro-endothelial effect. There may be much less powerful effects long term on mortality and MI rates (as well as other longterm adverse effects). There is much less data on that."

Katz' "plant-based awakening" occured after hearing Dr. Caldwell Esselstyn speak at a lecture three years ago. Learning about the "end-stage" coronary artery disease patients that Esselstyn treated by diet alone, and especially seeing the angiograms that showed disease reversal was the "game changer" for Katz. This was something that he previously thought was impossible.

Before that time, he considered heart disease to be a terminal illness--you could slow it down a bit, repair blockages, but you couldn't prevent or reverse it.

After hearing Dr. Esselstyn's lecture, and following up with his own research, Katz has since changed his mind about the major effect that diet can have on heart disease: specifically, a plant-based no-added oil diet. Beyond Esselstyn's work, he found a building body of evidence showing that heart disease can be prevented and often reversed.

And then he changed his own diet.

After hearing Dr. Esselstyn's lecture, Katz attended Esselstyn's day-long session at the Cleveland Clinic, and changed his own diet.

Like many of us, this 50-something surgeon had put on weight over the years, and his cholesterol was climbing, too. After switching to a plant-based no-added-oil diet, he lost 35 pounds over just a "very few months", and his cholesterol dropped by 1/3 without any drugs. In his opinon, "These were great results."

What's Katz eating now?

Breakfast: Chai tea with non-fat soymilk, a whole grain English muffin with homemade no-fat hummus; a piece of fruit like an apple or a banana

Lunch: a salad

Dinner: usually mixed grains, like quinoa and vegetables

Nuts are only an occasional treat for Katz--and he limits those to walnuts & chestnuts when he does indulge.

No seeds

Absolutely no olive oil.

For omega-3's, he sticks to flax meal, on a daily basis.

He credits his wife for making the diet such an easy transition. Not only is she a terrific cook, but she's 100% onboard with following a plant-based diet.

Dr. Marc Katz' Interview Highlights

Why is there so much cardiovascular disease?

There's no question that it's diet related. We're getting fatter, and eating worse than ever before. Colorado is the only state in the nation where less than 20% of the population is obese. In 49 other states, the obesity rate exceeds 20%--and we're not talking about just being overweight. The dietary causes for heart disease & obesity are eating too much fat, too much refined food, not enough fiber, not enough plant protein, and not enough whole foods. 80% of cardiovascular is preventable by diet.

In your opinion, what causes coronary disease--cholesterol or inflammation?

The biggest issue is inflammation of the endothelium--the single layer of cells that line the blood vessels. Animal protein & fats have been shown to be very inflammatory to blood vessels. Both Drs. Caldwell Esselstyn & William Castelli, the lead researcher in the Framingham Study, cite the example of the Nazi occupation of Norway in World War II, when all the livestock in the country was consfiscated, meat & milk consumption dropped, and heart disease deaths plummeted. After the war, when the livestock returned, so did heart disease. On the other hand, those countries with the highest percentage of calories coming from unprocessed plant food also have the lowest incidence of heart disease & cancer.

You recommend "no-added fats" whatsoever for anyone trying to reverse heart disease. What about fish oil?

Yes, no oil whatsoever, including fish oil. Katz gets his omega-3's from ground flaxseed, daily. He seems unconcerned about the issue of conversion of the short-chain omega-3's (ALA) found in flax into the long-chain omega-3's (EPA/DHA) found in fish oil. [H.L. We'll save that discussion for another post.]

What's the breakdown of your cardiac surgery caseload? How much of it is for coronary artery disease?

How much nutrition education do you now give to your heart surgery patients?

I speak to all of them before & after the surgery--and give them the evidence that this disease can be halted &/or reversed if they're willing to make major diet changes. Before the surgery, if their coronary disease is stable, I explain that if they are willing to do this, it may be something they want to try first--before going ahead with surgery. Post-surgery, all heart surgery patients are put on a low-fat whole plant-based diet while they're in the hospital, and given diet recommendations to follow when they go home. However, Katz suspects that the number of patients who actually follow-through with all the recommendations when they go home is small.

If you had 20 patients who were 100% compliant with their diet--how many do you think could avoid surgery?

If someone has unstable symptoms--then they need to get out of trouble with surgery or a procedure, first. But, if they are stable, it's hard to say--I don't know of any randomized study on this. I can only give you a guesstimate. Perhaps, 40-50% could potentially reverse their disease. As for the others--by following this diet protocol--even halting the disease & not necessarily reversing it--that would still be a huge advantage & benefit for them.

Do you think cardiac surgeons would be looking for work if we did our jobs right--and everyone switched to a plant-based diet?

Absolutely!!

How can we motivate people to make major lifestyle changes?

I used to think that "splitting" the breast bone during cardiac surgery would be motivation enough to get someone to change their lifestyle into a hearty healthy one. Everyone's motivated when they're in the hospital, but they often lose that motivation & fall off the wagon when they leave the hospital & get immersed into the busyness of life. Katz thinks you have to start with small goals, and build on those--making small dietary changes--one at a time. Make goals attainable. Practice small changes. Turn those into habits--and then continue to add more. [H.L. Sorry, Dr. Katz--I think a more aggressive approach with more active hands-on education, nutritional counseling, cooking, shopping, label-reading instruction, group support & follow-up is necessary.]

If you were the "Health Czar" what would your top recommendations be?

1. A whole food plant-based diet

2. Daily exercise

3. A good preventive health care regimen--not just showing up in the ER for your health care.

If you learned that your doctor followed a plant-based diet--would that motivate you to change your diet?

What do you think works best? The step-by-step approach to making diet changes, or doing it all at once?

The newly-plant-strong son convinced his not-so-healthy Medina, Ohio Police Chief dad to just give the diet a try. It worked for Bill Clinton--it'll work for him.

When the Police Chief started losing weight & gaining energy, he convinced his officers to give the diet a try.

Then the Police Chief decided to take it a step further & get his whole community turned-on to all the health benefits of eating plant-based--so he invited Dr. Caldwell B. Esselstyn, Jr & his wife Ann to explain all about the diet at the Medina Performing Arts Center.

The plan: to make Medina into a "Heart-Healthy City"

That was last night.

The community came out in full force to hear Dr. Caldwell B. & Ann Esselstyn explain how they can become a "Heart Healthy City--packing the Medina auditorium.

The front row was filled with police officers--and I'm pretty sure the mayor was there, too.

How lucky that Chief Patrick Berarducci listened to his son's pleas to do something about his health.

How lucky for Partick Berarducci, Jr., that his dad took his advice to heart--and turned his health around. Not many parents are willing to do that. What a gift this father & son gave to each other!

"The greatest gift that you could possibly give to your family--you can make them aware of this incredible power to avoid life's most painful events. You just don't have to have those kinds of events."

-Dr. Caldwell B. Esselstyn-

How lucky for the city of Medina, Ohio that they have a Police Chief who wants the entire community to "crack down" on heart disease.

And the delicious part for everyone in the Northeast Ohio area---Chief Berarducci wields a lot of influence in the local restaurant community.

Rumor has it that at least two Medina restaurants, Sully's & Thyme, are more than willing to turn out plant-based oil-free dinners for the Police Chief--so, I'm guessing that they'll know exactly how to prepare healthy meals for everyone else who's looking for plant-based fare in the Medina area .

Ann Esselstyn told me that the dinner she & Dr. Esselstyn had in Medina last night was absolutely outstanding--and prepared by a local restaurant, exactly to Chief Berarducci's oil-free specifications!

Trimmed-Down Medina Police Chief is Sharing Secret of Success with Community

I started to just include the highlights--but, frankly, the article is just so good, I'm reprinting it all right here. Please, please go ahead & click on Jake's story so he'll get credit for lots of internet traffic!

Trimmed-Down Medina Police Chief is Sharing Secret of Success with Community

"The 61-year-old Medina resident and 37-year law enforcement official is cracking down on heart disease.

Over the last three months, Berarducci has lost nearly 40 pounds while following a ground-breaking diet that was designed by Cleveland Clinic doctor Caldwell Esselstyn Jr., who will speak at the Medina Performing Arts Center next Wednesday. Dr. Esselstyn claims that the diet makes a person heart attack-proof.

“I’m going to do whatever I can to protect my health and be here as long as I can, and I haven’t been disappointed,” Berarducci said of the diet.

'Dad, you need to do something.' How & why Berarducci went plant-strong

His wife, Judy, and two grown children had become increasingly worried about Berarducci’s rising weight and climbing blood sugar, which required Berarducci to take 20 mg each day of Crestor, a medication to regulate cholesterol.

On the weekend of Sept. 4, Berarducci’s son, Patrick Jr., made a plea. (according to HL's sources, Patrick, Jr. learned about the Esselstyn diet when he attended an Engine 2 Immersion weekend in the summer)

“He said, ‘Dad, you need to do something,’” the elder Berarducci recounts. “To me, I’m a cop, I’m used to somebody showing me the evidence. I’ve got to understand it.”

Show Me the Evidence

So Patrick Jr. did. He showed his father a recorded CNN special, “The Last Heart Attack,” that features Dr. Esselstyn’s research and a story about U.S. President Bill Clinton, who, despite having world-class health care, needed bypass surgery only a couple years after leaving office.

It was a wake-up call to Berarducci, who formerly worked as a federal agent and knew the protective measures exerted for the President, including strict health care. If it could happen to someone on such a formulated and planned diet, it could happen to a local police chief.

“What do we do?” Berarducci asked his son. His next meal was on Dr. Esselstyn’s diet, and he has not looked back.

The Challenge of an Ever-Shrinking Waistline

Since September, Berarducci has lost 38 pounds and has had to invest in a tailor.

“The big problem now is I have to continue to have my clothes taken in,” he said. “That’ll be a price I’m willing to pay.”

Berarducci's Cardiovascular Fitness Has 'Skyrocketed' with Exercise

He has lost 11 percent of his body weight, and Berarducci, who works out at least five hours per week, says his cardiovascular fitness has “skyrocketed.”

“I’m doing miles instead of blocks,” he said.

Prior to starting the diet, 30 minutes of walking was a strenuous workout, but now, Berarducci rips off a one-hour walk with ease, even after 12-hour days. “You just don’t get tired,” he said.

The Heart Attack-Proof Lifestyle

The heart attack-proof diet, which is based on a 20-year study by Dr. Esselstyn, is plant-heavy and rejects the use of oils in cooking.

In his book, “Prevent and Reverse Heart Disease,” Esselstyn details his study and 150 heart-healthy recipes. Read more here.

By following the diet, food has come alive to Berarducci. Lentil soup over spinach, whole-wheat tortillas, whole wheat pasta: It’s like eating for the first time.

“The food you taste is so good, and I don’t remember feeling that way about normal food,” said Berarducci, whose wife is cooking through each one of Dr. Esselstyn’s recipes. “I’ve not enjoyed my meals in the past like I do now.”

Medina, Ohio--Where the Restaurants Now Make Plant-Strong Fare

And he’s taken his new diet out — to Sully’s, Thyme, and other local spots.

Berarducci will tell the chefs what he can and cannot eat, and the chefs’ creativity will flow out, producing new and unique dishes.

“To me, it almost looks like chefs are getting to be chefs. They are getting to prepare foods that they normally don’t get to,” Berarducci said.

As Berarducci’s weight plummeted and he continued to evangelize the diet, other police department employees began using the diet. But he could not stop there.

Like any good safety official, Berarducci wanted to protect the whole Medina community. He invited Dr. Esselstyn to present the diet to those in Medina City.

“I’m so thankful that my son didn’t give up on me and he got the message to me,” Berarducci said, “and I’ve kind of taken that on for the community.”

I want to give a shout-out to my blog-buddy, plant-strong grandmother extraordinaire, Bonnie, who I finally had a chance to meet in person on Sunday. She has her own inspiring story! Bonnie's the one who told me about the upcoming event in Medina. I know you were there, Bonnie. Care to fill us in on the evening's events?

And I thank Ann Esselstyn & Jake Poole for filling me in on all the details of Berarducci's story!

Go, Chief Berarducci!!! We'll all be looking to Medina, Ohio for inspiration.

Every single week I hear motivating stories from readers who have switched to a plant-strong no-oil diet & are blown-away by the results. They can't believe how easy it was to make the switch.

Son #1: Hey mom, did you see that video of Dr. Esselstyn--where he gets into a cab, and there's already another passenger sitting in it--and this guy says to him, "Aren't you Dr. Caldwell Esselstyn?"

And then the guy in the cab tells Dr. Esselstyn how he's come all the way to LA from Wales just to hear him speak. Turns out, many months before he was having chest pains--went to the emergency room, failed his stress test, got a load of pills, but, he didn't like the survival odds the doctors gave him.

So he starts doing his own research to see how he can improve his odds of survival; finds Dr. Esselstyn's journal articles; decides to follow the diet---and now he's angina-free & off of all his meds.

Me: What? No, I never saw any video like that. Where did you see it? You never watch that kind of stuff.

Son #2: Hmm. Honestly, I'm not sure. Could be that DIL #1 had it on her Facebook page or something like that. Don't really know. I think maybe her computer was sitting on the kitchen counter as I was making dinner one night--I felt like listening to something while I cooked--so I just clicked onto this video. But, what an inspiring story. And the whole thing was so random, how Dr. Esselstyn & this guy just happened to meet in a cab.

By now I was very curious.

You have to understand. Son #1 hasn't even seen Forks Over Knives. He avoids Facebook, and I can't imagine him watching a YouTube video that's over 6 minutes long--especially one on heart disease. There's just no way.

So, I asked DIL #1 (his wife--my daughter-in-law) if she knew what Son #1 was talking about. Turns out, this video was posted on Dr. Esselstyn's Facebook page, not long ago--we tracked it down--and I watched it. (Note: I, also don't use Facebook--which explains why I never saw this video. But, that should change in about a week. Son #1 convinced me it was a good idea. He, of all people??!!)

As for the video--I totally agree with Son #1. It's a great story. Two men randomly meet in a cab--and Peter Lewis ends up sharing his story with all of us!

Me to Son #1: But, I'm still wondering why you bothered to watch this video through til the end. Why?? Here's what he told me:

It was such a random way that Dr. Esselstyn & Peter Lewis met. And then, Dr. Esselstyn spontaneously asks him to speak to an large audience, without a bit of preparation.

I was taken in because Peter was so fit--a mountain biker--and he still got heart disease. (Son #1 also mountain bikes & he's fit--maybe this hit close to home.)

Plus, Peter is a professor, he understood the research, and he wanted better odds for survival than his doctors were offering him--with drugs or stents.

I'm not a huge fan of posting YouTube videos. Personally, I'm usually too inpatient to watch videos--and I figure, if I'm annoyed by them, maybe my readers are, too. I prefer the written word. It's much easier to refer back to.

But, in this case--listening to Peter Lewis tell his own story is more compelling than just reading a transcript.

Peter, I wonder if I could get you to come up here a moment. I've known Peter for about 25 minutes. I was coming in from the airport & I crawled into this filled cab, and I saw this beaming face that I didn't recognize, & this man says, "You're Dr. Esselstyn, aren't you?" And then he proceeded to tell me this story. Since Peter is a professor, & he's used to being on his feet, I wonder if you can take just a few minutes & share your story with us, Peter.

Peter Lewis: (Slightly embarrassed, completely surprised, and very charming) This is totally out of the blue. 15 months ago, I thought I was pretty fit. My sport is mountain biking & I regularly ride with my 35 year old son, & I keep up with him--and he's pretty keen.

But, then, while I was helping my son do some gardening, 15 months ago, I felt this pain in my chest. I thought, "muscle pain", and dismissed it. But, it didn't go away & I ended up in the hospital emergency room, and I had to stay the night.

The next day, I was released with a bag of pills. On the way to the "car park", I had to walk up a gentle hill & the pain was so great that I had to stop. I had it fairly bad--I had a treadmill test in the hospital. I managed 4 minutes on the treadmill--less than 1/2 of the length of a normal test. So, I was in bad shape.

(When I got home) I looked on the internet to see what my prospects were--and they were pretty bad. They talked about improving your risk for survival. And the best medication you could get would only help lower your risk of getting a heart attack or dying.

So, I carried on with the internet, & came across a paper by Dr. Esselstyn, and what he said was, "I can eliminate your chance of having a heart attack." He had this study of 18 people who previously had collectively 49 cardiac events---and 12 years later, after they'd been on his diet, they had ZERO.

I thought, "That's the number I want! Zero." I didn't want a 5% or 10% risk, because if you're the 5% or 10% who have a heart attack, it's 100% for you! I want zero.

So, I read the paper, immediately followed the recommendations, & I went immediately on his diet. I calculated the fat content of what I was eating & it was someting like 7-8% or less. And I stuck on that diet.

I've got a research background, so I thought "I'm going to measure my improvement. I've got a standard bike route that climbs up behind my house--about 700 feet, & the first part of it is fairly gentle."

Immediately, when I started this test, I had to stop 7 times from pain during that first little bit. Then, as the weeks went by, it was 6 times, then 5, 4, 3, 2, and 1 time. Then I managed to do the whole bottom section with no pain--or pain that was manageable.

I thought, "All right. I'll go on to the next section." It's steep up into the woods. Rough track. Tough. So I had to stop 3 or 4 times going up the steep part--because I was obviously much better.

Then that went down & I started to be able to ride the whole hill with no stops. So I started dropping some of my medications, Nicorandil, a vasodilator--gradually. Within 6 months, I virtually eliminated my angina--I was able to ride my bike trip all the way, without stopping & I was dropping my medication.

Now, 15 months later, I TAKE NO MEDICATION, & when I saw Dr. Esselstyn in this taxi, I said, "I'm here because of you!"

Because if you're doing this, and you believe so passionately in it, you want to help other people experience the benefits that you've had--but it's hard. People tend to treat you like "a different sort of person". They don't really want to know.

So, in order to feel geniunely inspired, I needed to come somewhere where I'm surrounded by people who believe the same things I believe, & perhaps experience the sort of things I experienced.

That's why I'm here.

Like my son, I'm also inspired by health-turn-around stories--especially, from people who thought they were fit--they exercised, and ate right--or so they thought.

I've never had a Sri Lankan dish, and it sounded like a good plan for last night's dinner.

The Lab Rat was up for the challenge--so that's what we ate for dinner last night. He doubled Quinny's recipe--using 3 large sweet potatoes, 24 ounces of kale, 2 big onions, and 2 cans of black beans.

Honestly, this recipe is enough for 8 servings--not four. I'm also thinking that a little pineapple in it, next time, would taste great. As for the not-so-healthy addition of unsweetened coconut--spread over 8 servings gives you about 4.1 grams of fat, according Susan Voisin, the Fat-Free Vegan and my nutritional info. How's that for rationalization? The coconut & lime really made this dish something special.

It looks like a nutritional power-house to me, in spite of the coconut.

Nutrition Facts

Quinny's & Fat-Free Vegan's Kale, Sweet Potato,Black Bean Mullung

Serving Size: 1 serving

Amount Per Serving

Calories

249

Total Fat

4g

Saturated Fat

3.1g

Trans Fat

0g

Cholesterol

0mg

Sodium

218mg

Carbohydrate

45.8g

Dietary Fiber

10.3g

Sugars

13.3g

Protein

10.4g

Vitamin A 312%

Vitamin C 220%

Calcium 25%

Iron 26%

The Benefits of Flax & Chia Lignans for the Prevention of Breast Cancer

Thanks again to blog reader Tom, who emailed me yesterday's Disease-Proof posting that explains how the lignans in flax & chia help to prevent estrogen-driven breast cancer. One more reason to add a tablespoon or two of flax or chia seed on top of your morning oatmeal! Fiber, omega-3s, & cancer-fighting lignans. 3 for 1.

The latest study on the subject just appeared in the October 11, 2011 issue of the British Journal of Cancer, "Estimated enterolignans, lignan-rich foods, and fibre in relation to survival after postmenopausal breast cancer." Read more here.

Excerpt from the Disease-Proof Blog:

"Women eating more flaxseeds with a documented higher serum enterolactone were found to have a 42% reduced risk of death from postmenopausal breast cancer and a dramatic (40 percent) reduction in all causes of death.14,15Flaxseeds are clearly super foods; even with a mediocre diet they offer powerful protection against certain types of breast cancer.

Another interesting study on flax followed women for up to 10 years and found a 51% reduced risk of all-cause mortality and a 71% reduced risk of breast cancer mortality."

"A diet high in fruits and vegetables appears to mitigate the genetic risk of a heart attack.

We observed that the effect of a high-risk genotype (variations of chromosome 9p21) can be mitigated by consuming a diet high in fruits and vegetables.

Our results support the public health recommendation to consume more than five servings of fruits or vegetables as a way to promote good health."

Sonia Anand, is the study's joint principal investigator, a researcher at the Population Health Research Institute and a professor of Medicine and Epidemiology at the Michael G. DeGroote School of Medicine at McMaster University. "The Effect of Chromosome 9p21 Variants on Cardiovascular Disease May Be Modified by Dietary Intake: Evidence from a Case/Control and a Prospective Study," PLoS Medicine, published ahead-of-print on October 11, 2011.

If you received this post via email, click here to get to the web version with all the links.

For almost three weeks I barely looked at my computer, read a medical journal article, listened to NPR, watched television, or read a newspaper. But, somehow, even I didn't miss this exciting Canadian diet/gene article!

I was busy enjoying the deliciousness of caring for a sweet toddler, while my son & daughter-in-law were hard at work bringing a gorgeous healthy baby girl into the world. I'd say 56 hours of labor was hard work!

And what more exciting news is there than a new baby?

I was doing the most important work I could think of at the time--playing & snuggling with my grandkids, reading picture books, going to the playground, coloring, preparing meals, grocery shopping, negotiating with a 2 year-old, doing lots of laundry, changing diapers, washing dishes, and best of all--giving "Beginning of Life Care" to my family. Absolutely the best! Stay tuned for more on that story...

Their study is the largest gene-diet interaction study ever conducted, and it encompassed multi-ethnic & racial groups--Europeans, South Asians, Chinese, Latin Americans, & Arabs. You heard right--the 9p21 gene exists in all racial & ethnic groups. It's not just a Caucasian thing.

What's Up with This 9p21 Chromosome? Explaining the Back Story - Its Inflammation Connection

The 9p21 chromosome is the most robust gene ever associated with heart disease.

Since 2007 scientists from all over the world have identified variations of this gene that are linked to cardiovascular disease & heart attacks. This is a proven unquestionable finding. If you have one or two copies of this gene--your risk of heart disease goes up. How much? Who's stuck with this gene? More on that later...

Researchers already knew that this gene was bad news for heart disease, but it was only recently that they figured out how & why it caused so much damage!

The missing puzzle piece? The 9p21 gene is an inflammation driver. It does its dirty work by increasing inflammation in the endothelial cells that line blood vessels! This is a huge AHA discovery!

If you carry this gene you are at a higher risk of coronary & arterial diseases because it makes you more susceptible to inflammation than non-carriers.

It explains why 9p21 affects not just risk of coronary artery disease, but also aneurysms--because inflammation, as well as causing atherosclerosis, can weaken artery walls."

And according to Dr. Kelly Frazer:

"[I]t opens up ways of thinking about people who have this particular [9p21] variant as a susceptibility--you may want to monitor their inflammation more than other aspects--eg, cholesterol--because when people think about coronary artery disease, they tend to always focus on cholesterol." (for inflammation, think about the C-Reactive Protein (CRP) Test)

A diet high in omega-6 oils and the long-chain omega-6s found in grain-fed meat, saturated fats, trans fats, too little sleep, too little exercise, refined grains, too little fiber, too much sugar, abdominal belly fat, and a diet low in fruits & vegetables? Are you beginning to connect even more dots? Does this help to explain why a plant-based no-added oil diet is protective against cardiovascular disease?

Why Vegetables & Fruit Can Mitigate the Risk of the "Heart Disease" Gene

Once you know that having the 9p21 gene makes one more susceptible to inflammation, you can better understand why people who have this gene might decrease their risk of heart disease by eating lots of inflammation-inhibiting fruits & vegetables. You know--the "anti-oxidant effect".

But, wait a minute! The McGill/McMaster Diet-Gene-Heart Disease Interaction Study was going on long before anyone knew that the 9p21 gene was responsible for vascular inflammation--which makes the study's results even more exciting.

How the McGill/McMaster Diet-Gene Interaction Study was Set Up

The Canadian researchers looked at two large international study groups totaling more than 27,000 people--from both the INTERHEART Study & the FINRISK Study--and identified which people had copies of any of four varieties of the 9p21 gene.

They compared the eating habits of those who had the gene with those who did not. And then they looked at who had a myocardial infarction--and who did not--and compared that with their eating habits & their genes.

The result: The people in the study who ate a "Prudent Diet" that was high in raw vegetables & fruits lowered their risk of heart attack even though they had the high risk gene.

Having this gene increases your risk of heart attack. It was discovered in 2007 & since then, many investigators have replicated this finding--so we really understand the effects of this gene quite well.

If you have one copy of the bad gene, or 2 copies of it, you have a significantly increased risk of a heart attack.

People who ate a healthy diet, even with an increased risk from the gene, lowered their risk. Please explain.

First we confirmed that the 9p21 gene was a risk factor, & then we looked at whether a diet high in raw fruits & vegetables would protect someone with the gene, from heart disease. It turned out that it did.

Then we looked at groups of people in different combinations, dividing people up by their gene status, and their dietary habits. We found out that if you had the "bad gene" & consumed a "bad diet" that was low in raw fruits & vegetables, your risk of a heart attack was increased by 30%.

But, if you had the "bad gene", and consumed a "good diet", high in raw vegetables & fruits--your risk of a heart attack was no different than those who did not have the "bad gene". So, the risk was brought down back to 1. (Note: Other lifestyle factors also affect one's risk of heart disease, e.g. physical activity, smoking, obesity, alcohol consumption, etc, regardless of one's genes. This study looked only at how diet can affect those with a genetic risk of heart disease, as compared to those without a genetic risk. In most common diseases, both lifestyle & genes play a role. The 9p21 gene ups the risk of myocardial infarction by 1/5 over those who don't carry the gene.)

Do fruits & vegetables have some mechanism to turn the gene off, or affect how it's working?

From this broad population observation, we believe that it's true--there are good properties within the raw fruits & vegetables that actually silence or turn off the gene.

We don't understand how, and I believe that future studies should be focused in this area to understand at the level of the DNA what actually happens when people are consuming high quantities of fruits & vegetables.

Could you tell from the study which fruits and vegetables were the best at silencing the gene?

We conducted the first study in 5 different ethnic groups (the INTERHEART Study included Europeans, South Asians, Chinese, Latin Americans, & Arabs) and the main driver of the protective effect of this diet appeared to be among people who consumed RAW vegetables & fruits.

We then wanted to test our observation in a second study--and looked at the FINRISK Study from Finland. They measured diet slightly differently than in the INTERHEART Study. We found in that study, that any vegetable, both raw & cooked--or fruit or fresh or frozen berries seemed to have a protective effect. So, I think that any of those--raw or cooked vegetables, fresh or frozen fruit or berries--are likely protective. My comment: Should we consider the ORAC Index or Dr. Joel Fuhrman's ANDI -Aggregate Nutrient Density index?

How many people have the 9p21 gene? What percentage of the population has 1 or 2 copies of these genes?

50% of the population carries one copy of the "bad gene".

20-25% of the population carries two copies of the gene. So it's actually quite a common gene.

*To clarify these figures:

"9p21 occurs in 75% of the population except for African Americans and is associated with a 25% increased risk for CAD with 1 copy and a 50% increased risk with 2 copies. Perhaps the most remarkable finding is that 9p21 is independent of all known risk factors, indicating there are factors contributing to the pathogenesis of CAD that are yet unknown. 9p21 in individuals with premature CAD is associated with a 1-fold increase in risk, similar to that of smoking and cholesterol."

Does diet affect the risk of heart disease equally--or does the risk go down equally if you have both genes?

If you have two copies of the "bad gene" & you are consuming a "bad diet"--your relative risk of a heart attack is increased 2 times, or 200%

If you have only 1 copy of the gene, and you're consuming a "bad diet", your risk of a heart attack increases about 60%.

So, two copies of the bad gene is worse than one copy--and any copy of the "bad gene" is worse than not having it at all.

Is there any way to know if you have a copy of the gene?

The genetic test is not widely available. Physicians don't use it in their risk prediction.

There are some private companies that people can send their saliva or a blood sample to--and pay out-of-pocket to get this testing. But, I think that outside of the research context, our findings should encourage all people to increase their fruit & vegetable consumption, because we know that high consumption of fruits & vegetables is not only protective against heart disease, it's also protective against stroke & some types of cancer.

In your study, how many fruits & vegetables did people eat during the day?

To be classified as a "high consumer", you had to be consuming fruits, vegetables, & berries in multiple servings per day--at least two was average--but likely, if we put our findings together with the public health recommendations, it would be eating at least five to six servings a day. That's the best advice! And a serving is the amount you can hold in the palm of your hand.

So, if you have a couple of servings a day, that would be protective?

That's consistent with our study, and we have observed that that amount of fruit & vegetable consumption can silence this "bad gene".

Can you get even "better silencing" if you eat more fruits & vegetables?

Well, we don't know of an upper limit--so we don't think there's a point where you can consume too much, or have adverse consequences. Other studies have demonstrated that the higher number of servings per day, the better your health. At least two per day--but likely more is better!

Do you think this study & the effects of diet on this gene explains why people who eat a healthier diet are healthier?

Well, it's one of the first clues between this observation of fruits & vegetables on health--and the potential interactions between a good diet & genes.

I think it's important because we often think that if something runs in our family, well, it's in our genes. There's nothing we can do to change it--but now we have a hint that perhaps we can silence our genes & change our family history by embracing a healthy lifestyle.

Were you able to find out what role exercise might have with the healthier diet?

Yes! In our study we looked at various factors that may alter the expression of this gene, and we really came up big with this signal from diet!

We didn't find that there are other interactions either positive or negative with other health behaviors, with respect to modifying this gene. But, I will add that whenever you divide the study population many many times, in difference subgroups, your results become less reliable, because you don't have as many people. That said, this study doesn't rule out the fact that exercise may turn off or enhance protective genes, but we can definitely see the observations of the protective effect of diet on the 9p21 gene.

Where will your research go from here?

In terms of research & next studies, I see three different lines of upcoming research.

First is at the basic science level--trying to understand how this type of diet may alter gene expression.

Secondly, we hope to replicate, replicate, replicate our observations in many other studies. Versus heart attack. Versus stroke. And the more we see this observation repeated, the more believable it will be.

The third line of research, which is pretty exciting, is trying to understand if an individual's knowledge of their genetic risk will actually alter their health behaviors. Will this informations cause more people to embrace a healthy lifestyle & diet, than if they didn't have this information?

What Does Dr. Eric Topol Think of the Canadian Diet-Gene Study?

Topol is one of the country's leading experts in cardiovascular genomics. He's a professor of translational genomics at The Scripps Research Institute, and Director of the Scripps Translational Science Institute in La Jolla, California.

It was his recent research that identified the 9p21 gene's inflammation connection.

Here's what Topol had to say about the Canadian study:

"The study findings suggest that lifestyle does matter, no matter what your genes have dealt you.

This suggests you may be able to do something about it [bad genes] if you follow a prudent diet that is rich in fruits and vegetables.

I think this is a very sound report. It's really one of the first solid evidence of this whole field of nutrigenomics. (the way genes interact with nutrients)

The researchers found a dose response. The worse the diet, the higher the risk of heart attack. The better the diet, the lower the risk."

It goes without saying, that probably none of this comes as a big surprise to anyone who has been reading this blog for awhile.

But, it helps to confirm & and perhaps explain how a plant-based diet that's high in nutrient-dense vegetables & fruit can prevent and reverse heart disease--in Dr. Caldwell Esselstyn's patients--and for those who have duplicated his diet on their own!

Sharon Kintz is the woman we profiled. A 66 year old woman--had a heart attack--she needed to have heart surgery & she said, "No!"

She's adopted a plant-based diet. She's very strict about it. She's been doing it for over a year & it's quite remarkable. Not only in how much she hasn't had any symptoms of heart disease, but in terms of her energy levels.

She could barely walk before all of this & literally now--a year later--on a plant-based diet, she's able to jump rope & has high energy levels.

CNN's Ali Velshi:OK, so the plant-based diet is good for your heart, but can you really get enough protein on this diet?

Dr. Sanjay Gupta: The answer is yes! The protein argument is a fallacy.

It's simply not true that you can't get enough protein on a plant-based diet. If you do even a little research you find out that broccoli has more protein per gram than most meat. Spinach has the same amount. And of course there's tofu.

People who do this diet feel good & have a lot more energy.

If you received this post via email--you'll need to click here to get to the web version with the videos & links.

Even though I watched the entire CNN "Last Heart Attack" special on Sunday--this promo really "Takes the Kale"for bringing home Dr. Sanjay Gupta's main point: Heart disease--the No. 1 killer in the U.S. is a food-borne illness. It need never exist. Food can cure it--and make you heart-attack proof!

Please take the four minutes to watch this promo--yes, even if you watched the special! I promise you--it's worth it.

Gupta comes clean with exactly what he learned after a year's worth of research on heart disease. Talking to the experts. Talking with patients. Studying the research. And Gupta's not just a TV doc--he's a practicing neurosurgeon at Emory University in Atlanta who graduated from the University of Michigan--undergrad & med school.

And if you missed "The Last Heart Attack" you can catch it again on Saturday, September 3 at 8:00 PM EST--or watch it now, without the commercials--right here!

Can Food Cure Heart Disease?

If you don't see this video on your screen, click here to go directly to it.

If you don't see the 2nd video on your screen, click here to go right to it.

Eating Your Way to Health--What About Protein on a Plant-Based Diet?

So, What About Those Energy Levels? And What Exactly Do You Eat on This Diet?

Yesterday, I was up at 6:00 am--and I ended up working much later than I expected. Like over 11 hours. Got home about 9:15 pm--and my day included about 2 1/2 hours of moving heavy medical journals from one floor to the next--on & off shelves & pushing a heavy journal-laden trolley between floors.

Good thing I had packed my "lunch box" with breakfast, lunch, & snacks. It easily got me through the day--until I could finally get home & eat dinner--at 9:30 pm.

Here's what got me through the day.

Check back for the Taco Salad, the No-Fat Creamy Chipotle Dressing, & the Chickpea & Spinach Burger recipes tomorrow--no time to post it right now--I'm off to exercise, and then I'm working late, again, tonight!

Half of all heart attacks come with no warning at all, making diet changes & diagnostic tests all the more important

Last night Dr. Sanjay Gupta told us, "I'm on a mission to never have a heart attack."

He has a strong family history of heart disease and like most of us, he wants to avoid medications, stents, and bypasses. None of these are without risk.

For over a year Gupta's been investigating "how to prevent a heart attack," speaking with the top cardiologists--as well as patients who have taken different approaches to treating their heart disease--from bypasses to stents to making radical dietary changes.

Gupta's documentary, "The Last Heart Attack", aired last night, and frankly, its tenor and its key points took me by surprise. It wasn't about cutting-edge drugs or snazzy procedures. It was all about utilizing the newer more accurate non-invasive diagnostic tools--and making a radical change to a plant-based diet.

Dr. Arthur Agatston with his not-often-used non-invasive diagnostic tests, and Dr. Caldwell B. Esselstyn, Jr. with his plant-based diet--were far and away the stars of the show.

Gupta tells us at the start, "I'm going to tell you about things your doctor won't."

"And the truth is, it doesn't involve spending any more money, investing in any more research or creating any more tests. Rather, it will take a strict implementation of what we already know about diet and nutrition.

It will also take brave champions to navigate through confusing counsel, special interests and shoddy science," says Gupta.

Pretty audacious, I thought, but I couldn’t help but be engaged by this Cleveland Clinic surgeon, who was now devoting his life to preventing the diseases he made a living treating.

'We are never going to end the epidemic of heart disease with stents, bypasses and medications,' he told me.

That was music to my ears, because I didn’t want any of those things. Of course, it would involve essentially eliminating meat, dairy, eggs and oil – even olive oil.

'Nothing with a mother, and nothing with a face,' the good doctor added.

Virtually eliminating heart disease – it can be done, and truth is, we have known for a very long time how to do it.

People have said to me as I was preparing this documentary – 'Sanjay, you are advocating a radical change to the way we eat.'

Perhaps, but if you really think about it, the way we eat now is in fact more radical. And when we look back on this time, a couple of hundred years from now, I guarantee you that our diet of today will be considered one of the most radical in history.

If we collectively ever want to get to the point where we have “The Last Heart Attack,” a good start would be to stop ignoring what we already know to be true."

In spite of having the best health care from the country's top physicians, Clinton still ended up with quadruple bypasses, two stents, & medication. And even Clinton knew he was heading into trouble if he didn't do something serious about changing his diet.

Clinton had the trifecta of heart disease risk: he had a family history of heart disease, he was overweight & out-of-shape, and he was eating all the wrong foods.

When Clinton's stents failed in February of 2010, his doctor said, "This isn't a result of diet or exercise--it's a mechanical failure of stents." But statins, stents, & the Mediterranean Diet aren't always enough to stop heart disease. And moderation & pharmaceuticals aren't enough to stop the onslaught of atherosclerosis.

Last year Clinton decided to hit the books & read what the medical literature had to say about preventing and reversing heart disease through diet. He discovered that there is only one way to do this--a strict plant-based diet loaded with green leafy vegetables, and without meat, chicken, fish, dairy, or added oils. The two physicians who pioneered this type of treatment are Dr. Caldwell B. Esselstyn, Jr. and Dr. Dean Ornish. With nothing to lose, Clinton decided to conduct his own personal clinical trial.

For over a year he's been eating 100% plant-based, if you don't count the one single bite of turkey he ate at Thanksgiving. No dairy, no meat, no fish, and almost no oil.

First of all, Clinton unabashedly says, "I like the stuff I eat. And if anything, I'm getting stricter about my diet as time goes on." He's lost 27 pounds, all his blood tests are good, he has more energy, needs less sleep, and feels great. He's almost down to his lowest weight since high school--185 pounds.

The Three Tests That Can Predict a Heart Attack

Dr. Arthur Agatston, the cardiologist who created the best-selling South Beach Diet, recommends three relatively new tests if you want to get a far more accurate picture of your heart attack risk than you can get from cholesterol numbers.

Coronary calcium scan. This looks at plaque in the arteries leading to the heart and can provide a good indicator of one's risk of a heart attack over the next 4-5 years. This is a better indicator than you'll get from the Framingham Risk Score--and Agatston believes it should be done routinely at age 50--and earlier for people with a family history of heart disease. Full disclosure, though--Agatston invented the coronary calcium scan--but makes no money on it.

Ultrasound of the carotid artery. This looks at plaque in the main blood vessel leading to the brain. Plaque in the carotid artery is a sign of increased risk for a heart attack & a stroke.

An NMR lipid particle test (The NMR-LipoProfile) This is a $65 test that looks at the size of one's LDL--the bad cholesterol. Patients with a lot of small-particle LDL are more likely to build up plaque in their arteries. The larger, light & fluffy LDL particles are less likely to enter into the blood vessel walls & cause damage. It's not just about the LDL level--it's about the size of the particles.

According to Esselstyn, heart disease is a food-borne illness, and one's risk of having a heart attack is not sealed in stone by one's family history or genetics. If you change what you eat--and you can make yourself heart-attack proof. Click here to learn more.

Esselstyn looked at the diets of indigenous people around the world. In the communities where no heart disease existed, it turned out that the people were eating a mostly plant-based low-fat diet: The Papua New Guinea highlanders, the Tarahumara Indians of Mexico, and some rural Chinese.

Gupta followed up with his own research, checking the medical literature for sound studies on the use of plant-based diets to prevent & reverse heart disease. He was impressed with Dr. Esselstyn's research at the Cleveland Clinic.

5 years later no patients who followed the diet had another cardiovascular event

Three-quarters of Esselstyn's patients saw their blockages reduced.

There are detractors: Dr. Allan Schwartz, the New York-Presbyterian Hospital's Columbia cardiologist who put in Bill Clinton's stents in February 2010 says the idea that diet can prevent or reverse heart disease is an overstatment.

Dr. Erin Michos, a cardiologist at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University, says diet can reverse heart disease, but some people just aren't willing to make the necessary changes.

Gupta points out that Dr. Esselstyn's diet prescription runs counter to the powerful lobbies of the meat, dairy, & egg industries--not to mention our fast-food culture. Could that be another reason that it hasn't gone mainstream?

Most doctors & their families eat meat themselves, making them less likely to offer a plant-based diet as a prescription to prevent heart disease.

Two Patients Who Chose Diet Over Surgery to Prevent Another Heart Attack

The 41 year-old Male

He didn't smoke, was in good shape, and ate well. His was a case of bad genes.

At age 31 he already had eight stents placed in his arteries. At age 41 he had four more.

Clearly, stents weren't working for him. He decided to contact Dr. Esselstyn after learning about his successes last September through Wolf Blitzer's CNN interview.

No surprise that his doctors thought Esselstyn's diet was too extreme. "Unnecessary," they told him. But after having multiple stents he was losing confidence in their advice.

She's a 66 year old private investigator, who said, "NO" to open-heart surgery after experiencing a heart attack a year ago. Brave woman.

Her symptoms before the heart attack? Only fatigue & a pain in her jaw. All fairly typical for women.

According Dr. Esselstyn, there's no down-side to Kintz' diet approach. Once you start eating this way you will not have a heart attack. Kintz continues to be seen by her cardiologist, as well as receiving dietary guidance from Dr. Esselstyn. Her cardiologist is impressed with the results.

Kintz is a true believer in the diet approach & she's got plenty of company with some high-power business moguls like: Steve Wynn, Mort Zuckerman, Russell Simmons, Bill Ford, Biz Stone, and Whole Foods' John Mackey.

She also has the "how to eat plant-based no-oil" thing down pat when she's on the road, or traveling.

Tom Bare--The Science Teacher Who Opted for the Bypass--Not Interested in Making Diet Changes

Then there's Tom Bare. He's 54 years old high school science teacher, with none of the usual heart disease risk factors.

He was thin.

Ate what he thought was a healthy diet--oatmeal for breakfast, fruit, chicken or Mexican food for dinner

He was on a statin--& his total cholesterol had gone from 300, down to 125.

Exercised now & then

He took care of himself & his body

He didn't smoke

He wasn't diabetic

He did have a strong family history of heart disease

Bare did have one big risk factor hanging over his head. He had a coronary calcium score that continued to increase. Four years ago it was 111. Anything over 100 means an elevated risk. This year he had another scan--and this time it had gone up to 243!

One day this year, while out for a jog he experienced the classic chest pain, pain down his left arm, & shortness of breath.

His risk was all about coronary plaque--atherosclerosis--that narrowed all the major blood vessels of his heart.

Bare ended up with quadruple bypass. But that wasn't the end of his problems.

He had a slow painful recovery. Eight days after surgery he was heading for a life-threatening complication.

Seventeen days after surgery he had no idea how uncomfortable he would be.

Three weeks after surgery he was finally able to take his first walk outside--and that's when he started to experience chest pain & shortness of breath.

As it turned out--all his bypasses failed and he needed to have them all redone. His doctors had never seen anything like this before.

12% of bypasses experience serious complications

1 in 300 need a 2nd operation in 3 years

1 in 20 end up needing follow-up stents.

Bare was told that he'd feel like a million dollars. He doesn't.

He is now back to teaching part-time--until he regains his strength--and he's hoping that bypass surgery has given him a new lease on life. He's looking forward to being able to travel in the future.

"I'm told that I'm good for another 40 years or so, and I'm hoping that's the case, but with my history, I'm going to have to watch it."

August 18, 2011

Former president Bill Clinton's current goal is to avoid food that could damage his blood vessels

If you received this post via email, click here to get to the web version with all the links & video.

Ever since I learned that Bill Clinton had adopted a plant-based no-oil diet back in May 2010, I've been waiting for an update.

Was he still sticking to the Esselstyn-style plant-based no-oil diet?

Up until a week ago there was complete radio silence on the subject. I was going to have to wait until Dr. Sanjay Gupta's CNN special on Sunday August 21, 2011 at 8:00 PM EDT to find out what Bill was up to these days.

I was hoping he hadn't backed off & switched to Dr. Arthur Agatston's South Beach Diet.

Wolf Blitzer's Interview with Bill Clinton's Diet Gurus, Dr. Caldwell Esselstyn and Dr. Dean Ornish - What the Interview Didn't Have Time to Explain about How to Prevent and Reverse Heart Disease with a Plant-Based Diet

If you received this post via email, click here to get to the web version with the video and links. You'll find the video of the interview at the end of this post.

Yesterday my husband and I had the pleasure of watching Drs. Esselstyn & Ornish explain on national television just how a plant-based diet can prevent or reverse heart disease. Unfortunately, nine minutes can't do it justice. So here's the rest of the story.

February 10, 2010: Clinton has two stents placed in one of his previously-treated arteries, afterone of his bypass grafts completely closed up. According to his physician, Clinton had "toed the line" about adhering to diet, exercise & medical therapy. Click here for the Medtronic (the stent company) press release.

Spring, 2010: The stents fail to prevent further cardiovascular blockages. This is not an unusual occurrence. Clinton decides to read the medical literature about preventing and reversing heart disease. He discovers that there is only one way to do this--a strict plant-based diet loaded with green leafy vegetables, and without meat, chicken, fish, dairy, or added oils. The two physicians who are pioneers in this treatment approach are Dr. Caldwell Esselstyn and Dr. Dean Ornish. Clinton decides to conduct his own personal clinical trial.

Zero cardiovascular events have occurred in Dr. Esselstyn's original group of 17 compliant patients that he has followed for over the past 25 years. Esselstyn continues to work with hundreds of other patients who have similar success stories. There is no mortality, no morbidity, no expense from following a plant-based diet--if you eat in a way that makes the cap over your plaque super strong!

Like most Americans, Wolf Blitzer didn't seem to understand why bypass surgery or stents cannot cure cardiovascular disease. These procedures only treat emergency blockages. And statins are no guarantee that it won't happen again. Too bad Dr. Esselstyn didn't have a chance to tell Blitzer this:

"Some people think the "diet" is extreme. Half a million people a year will have their chests opened up and a vein taken from their leg and sewn onto their coronary artery. Some people would call that extreme."

"The elephant in the room when we talk about stents and bypass surgery--those procedures don't protect from new heart attacks. Stents & bypasses are used to treat large arterial blockages. Yet according to many research studies only a small percentage of heart attacks are caused by the largest build-up of plaque. The rest are caused by the more numerous newer blockages that are far more inflamed and much more likely to rupture than the larger older, more stable plaques. So this is why those procedures don't treat the disease. They are treating the symptoms."

"Multiple studies show that if you have one ruptured plaque you have many." -Dr. Steven Nissen, chairman of Cardiovascular Medicine at the Cleveland Clinic-

"We can't cure this disease until we address the fundamentals of lifestyle." -Dr. Eric Topol-

Wolf seemed surprised at Dr. Esselstyn's suggestion that the only way we will ever stop this disease is by changing the eating habits of our children.

"What? Are you suggesting that our kids shouldn't drink milk, or enjoy French fries, and chocolate cake-all the pleasures of life?" Blitzer asked.

Unfortunately, there wasn't sufficient time for Dr. Esselstyn to answer that question. But, if he had had time, here's what he might have said.

It All Starts in Adolescence according to the PDAY Study: Atherosclerosis begins in youth. Fatty streaks and clinically significant raised lesions increase from age 15 to age 34. 100% of the autopsies done on 15-34 year old accident victims showed fatty streaks in the aorta and 50-75% showed streaks in the coronary artery--all precursors to later coronary artery disease. Click here for study.

By 65-70 we all have it. All males 65 years & older, and all females 70 years & older who have been exposed to the typical Western diet have cardiovascular disease & should be treated as such. Without making any changes, you can expect to have a catastrophic event (a heart attack or stroke) in your 70's or 80's. -Dr. Lewis H. Kuller, The University of Pittsburgh-

Dr. Ornish waffled when he answered Blitzer's question about whether or not it was necessary for everyone to be on such a strict plant-based diet--even people without heart disease. Ornish suggests there can be a spectrum (the title of his latest book) of dietary strictness--based upon whether one has heart disease or not.

There's a bit of a problem here. Heart disease is often invisible, and it's years in the making. We often don't know what's going on inside of our blood vessels until it's too late.

Cholesterol levels, and other risk factors don't always predict future coronary events accurately. Cardiovascular disease lurks in the unseen damage we do to the endothelial linings of our blood vessels, from the foods we eat. This inflammatory process starts a cascade of bad-news biological events that lay down atherosclerotic plaque, damages vessel linings, and if we're unlucky, puts us at risk for vessel-blocking plaque ruptures--that set us up for heart attacks, invisible strokes, major strokes, dementia, and more.

Here are Some of the Questions the Interview Did Not Allow Enough Time to Answer

Why not just follow the Mediterranean Diet, which includes olive oil & fish? Yes, the Mediterranean Diet is better than the American Heart Association Diet & the Western diet, but it only slows the progression of heart disease--it doesn't prevent & reverse heart disease. And, sure who doesn't want to believe that it's healthy to eat fish & olive oil? I know I did. But followers of the Mediterranean Diet show reductions of only 19-25% in cardiovascular mortality compared to followers of more standard diets. Not a huge reduction in my book. Click here for a recent JAMA study.

Why can't I use olive oil? I've covered this at length in I'm Going to Miss My Olive Oil - Who Knew It Wasn't So Healthy After All? Drs. Esselstyn, Ornish, Vogel & Rudel Did but here's the short story: Dr. Lawrence Rudel fed African Green monkeys (who are close substitutes to humans for study purposes) olive oil for 5 years, and then compared their arteries to those of Green monkeys who were given saturated fat to eat. Rudel was shocked by the results--he expected the olive oil monkeys would be disease-free. Turns out even though the olive oil monkeys had high HDLs, they also had just as much coronary heart disease as the monkeys who ate saturated fat. Oops! Olive, soybean, palm, coconut, oils all contribute to heart disease--just avoid them.

Why can't I eat nuts? Recent studies say they increase HDL's, and lower LDLs? Esselstyn is skeptical about this reearch, based on the surprising results of Rudel's study. Just because the HDL's go up, & the LDLs go down, it's no guarantee that nuts are preventing or slowing down coronary heart disease. Little known fact: the nut industry has sponsored these cholesterol/nut studies & participants had to consume 2.3 ounces of nuts to accrue the lipid changes--that's 350-400 calories worth of nuts.

Then there's the omega-6 to omega-3 ratio thing--ideally we want to aim for a 2:1 or a 1:1 ratio of omega-3s to omega-6s, because a diet high in omega-6s is inflammatory. Most of us typically eat a diet that has a 17:1 ratio of omega-6s to omega-3s. Except for walnuts (and Esselstyn gives the OK for a few walnuts for folks without heart disease), most nuts are very high in omega-6s, and low in omega-3s. Cashews have a 117:1 omega-6 to omega-3 ratio. And all nuts are high in calories and saturated fat. Almonds, the nut super-star is 6% saturated fat.

Isn't This Diet Extreme? Isn't it Too Hard to Follow? Doesn't It Take All the Fun Out of Eating?

Not at all. I'm someone who LOVED Kentucky Fried Chicken, corned beef sandwiches, Big Macs, barbecued ribs, and eating chocolate chip cookies for breakfast. Don't miss them at all. And I'm following this diet just for prevention. I have no diagnosed heart disease. But I saw two wonderful parents go through lengthy stroke-related declines, and if there is anything I can do to avoid that future, I'm going for it! Honestly, if I can do it, anyone can. Really. By now I can't imagine eating any other way--and I'm eating delicious food with lots of spice and zest--and it's far more interesting than broiled chicken.

Yoda: So certain are you. Always with you it cannot be done. Do you hear nothing that I say?

Luke Sky Walker: Master, moving stones around is one thing. This is totally different.

Yoda: No. No different. Only different in your mind. You must UNLEARN what you have learned.

Luke Sky Walker: All right. I'll give it a try.

Yoda: No. Try Not. Do. Or Do Not. There is no Try.

If You Have More Questions About How a Plant-Based Diet Can Prevent Heart Disease--You're Welcome to My "Cliff Notes"

Nissen's eye-opening talk on intravasclar ultrasound, atherosclerosis, and reversing heart disease with high-dose statins didn't spend too much time discussing diet or lifestyle changes. But it certainly convinced me that I was on the right path--to keep on eating a plant-based no-added-oil diet, and to keep on exercising.

Why? Because, the inarguable evidence we now have from intravascular ultrasound (IVUS) demonstrates how very low LDL levels can absolutely make a difference in stopping the progression of atherosclerosis--ultimately reversing it.

Nissen, who is the chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, is one of the top & most respected cardiologists in the country. When reporters want an opinion about anything related to heart disease, he is the go-to expert.

What he has to say--and what his power points demonstrate--will convince you that our diet & lifestyle is highly atherogenic--that most of us already have coronary (and/or cerebrovascular) atherosclerosis--in spite of the fact that the majority of us would probably pass a stress test or have normal angiograms.

68% of men & 42% of women who have myocardial infarctions will have less than a 50% stenosis (narrowing) in their coronary arteries--and have no prior symptoms, until an atherosclerotic plaque ruptures from within their arterial wall. To understand how this can happen, click here.

Intravascular ultrasound (IVUS), is a diagnostic technique that's able to measure the arterial plaque withinthe arterial wall, as well as the opening (lumen) of the artery. It's used primarily in clinical studies, not for "regular" patients--because it's costly, time-consuming--and involves risk. But, it has completely changed our understanding of how coronary artery disease occurs--and more importantly, how its progression can be stopped, reversed, and prevented.

Cardiovascular disease (as well as carotid & renal vascular disease) is NOT a disease caused by the narrowing of the arteries.

The opening (lumen) of an artery can even look perfectly normal--because this isn't a disease of the lumen--it's a disease of the vessel wall--and angiograms & stress tests cannot pick up what's going on inside the artery's wall. It's all about that ever-present atherosclerotic plaque embedded inside of our vessel walls.

I'll say it again! Over half of the time this "Tim-Russert-kind-of-disease" of the vascular wall will not show up on a stress test or be seen on an angiogram--and often it won't cause angina or any other symptoms. Your cholesterol numbers might even be in the normal or high normal range--not high enough to warrant more than a low or medium dose of statins.

With standard diagnostic tools you won't have a clue about what's going on inside of your blood vessels. And besides, if you don't have angina or serious symptoms--you're never going to have a diagnostic test, anyway.

Stents & bypasses won't stop the disease--they'll just get you out of a crisis. And the typical normal dose of statins can only reduce cardiovascular disease by one-third.

How did we get into this mess? Blame can be placed squarely on our diet and lifestyle.

Sorry that the video of Dr. Nissen's lecture is no longer available. If it were, I'm certain you would come to one of three conclusions:

You'll want to take the highest dose of statins your body can tolerate in order to prevent heart disease or stroke--which isn't going to be an easy thing to do, because no physician would likely prescribe such a high-dose of statins just for primary prevention. And evidence continues to mount of increased side effects the higher the dosage, the longer one is on statins, & the older one's age.

You'll just give up thinking about all this prevention, plaque, heart disease & stroke stuff--eat whatever you want to eat, take what the doc prescribes, and let the chips fall where they may. You'll probably end up with some level of heart disease, peripheral artery disease, vascular dementia, or renal artery disease, because the cure seems worse than the disease.

You'll decide to change your diet from one that's atherogenic & slowly killing you, to one that's plant-based-with-no-added oil, because it will do exactly what the highest doses of statins will do without the side effects.

If by now I've convinced you to listen to what Dr. Steven Nissen has to say, just click here, and plan on spending one hour learning something that many physicians might not be aware of. And please get back to me--let me know what you think, and what you plan to do about it. You all know what I've decided to do!

Protecting the Brain & the Soul. Unplugging with a Shot of Nature

Son #2 doesn't spend much time surfing the net--and he rarely forwards articles.

Last May five neuroscientists headed into a remote canyon region of southern Utah for a rafting trip and some hands-on evidence-based brain research--on themselves. They wanted to find out what happens to your brain when you completely unplug from the world. No phones, no computers, no watches, no devices of any kind.

What the wanted to find out first-hand: Would you notice any changes to your brain or thought processes if you could immerse yourself in nature, really disconnecting from distractions, technology, constant interruptions, and your work, of course.

Would your focus and attention improve & sharpen without the usual distractions?

Would thoughts deepen, if noise & interruptions could disappear?

Is nature & silence restorative?

Or would you just feel even more anxious if you're cut off from your work, your techno gadgets--and your everyday world?

Starting out, two of the group were believers in the value of escaping into nature--unplugging--and resting the brain. The other three were skeptics--joined at the hip to their digital devices--and doubtful that the trip would affect them personally or scientifically.

"It was a primitive trip with a sophisticated goal: to understand how heavy use of digital devices and other technology changes how we think and behave, and how a retreat into nature might reverse those effects.

It is a trip into the heart of silence--increasingly rare now that people can get online even in far-flung vacation spots.

By extension, some scientists believe heavy multi-tasking fatigues the brain, draining it of the ability to focus.

As they head down the tight curves the San Juan has carved from ancient sandstone, the travelers will, not surprisingly, unwind, sleep better and lose the nagging feeling to check for a phone in the pocket.

[Dr.] David Strayer, the trip's organizer, a psychology professor at the University of Utah, says that studying what happens when we step away from our devices and rest our brains--in particular, how attention, memory, and learning are affected--is important science.

"Attention is the holy grail," says Strayer.

"Everything that you're conscious of, everything you let in, everything you remember and you forget, depends on it."

[Just the expectation of email or receiving new information seems to be taking up our working memory.]

Working memory is a precious resource in the brain. The scientists hypothesize that a fraction of brain power is tied up in anticipating email and other new information...

"To the extent you have less working memory, you have less space for storing and integrating ideas and therefore, less to do the reasoning you need to do," says [Dr.] Arthur Kramer of the University of Illinois.

"There's a real mental freedom in knowing no one or nothing can interrupt you," says [Dr.] Todd Braver of Washington University.

When he gets back to St. Louis, Braver plans to focus more on understanding what happens to the brain as it rests. He wants to use imaging technology to see whether the effect of nature on the brain can be measured and whether there are the other ways to reproduce it, say through meditation.

On Wednesday I'm starting out on my own journey that will disconnect me from my computer and cellphone.

Neither will get plugged back in until almost mid-June.

It's not exactly a backpacking trip or a silent meditation retreat--but I'll be visiting far-flung places. The first leg starts with a 20 hour road trip to celebrate & attend son #2's graduation--and then my husband & I will embark on multi-leg journey that's a pre-celebration of our 40th anniversary.

As soon as we return home, three of our favorite houseguests will have already arrived at our house--our #1 grandson, son #1, and daughter-in-law #1. Oops--I better thoroughly clean the house & get the bedrooms ready before I leave.

So...I've made the executive decision to leave my computer, my phone, and my blog behind for 3+ weeks and enjoy every moment of this wonderful month with my full attention--minus any distraction.

Learning to Let Go of "Crazy Busy"

I'm great at making myself crazy when I think I have too much to do.

You know what I mean. All that planning in your head that goes into preparing for a long trip. I'm not a "just show up & fly by the seat-of-my-pants kind of gal". I wish I was.

I'm the worst combo: a procrastinator who is also an "over-preparer"--who doesn't want to miss out on anything. Ugh! Turning easy into complicated is not a good thing--but I'm so good at it! I think too much--and then try to do it all at the last minute.

Researching the destinations--planning what I'm going to see & how to get there.

Buying the luggage (the old ones are too heavy), the comfortable walking shoes, the bathing suit (the old one is now too big), figuring out what to pack for every possible circumstance, the foreign currency, and all those little details necessary for travel

Planning a celebration-graduation-Friday-night dinner for son #2--Thanks to Eli, this one's going to be easy and amazing!

Fitting in all the pre-trip chores into my all-ready jammed-packed schedule

While also planning summer visits to North Carolina, Chautauqua, Boston, a family trip to Kentucky, and a July wedding shower. It's going to be a very busy summer! OK, I admit it--these all turned out to be easy-to-plan-events and I had plenty of help from others. It was just the "thinking about them"--and the procrastinating that made them seem so much harder than they were--and drove me crazy.

So it was perfect timing as I tried to fit in one last "before I leave" blog post that thoughts of Norman Fischer serendipitously flew into my head. Really.

I reread (and you can, too!) my October 25, 2008 Norman Fischer post about how to calm down when you think your too darn busy. And honestly, it worked.

So here's the serendipity part. I always have things I want to write about--too many. The problem is, it takes a lot of time to put thoughts to paper (or rather--to computer) and frankly, I've got lots of other stuff to do today. Like plant flower bulbs, put away my laundry, call my aunt, go for a walk, bake cookies for the new neighbors and hang-out with my husband. I've been mulling over writing posts on multi-tasking; strategies from positive psychology to get through tough economic times; yoga as medicine; and lessons from cultures with lots of centenarians & so on.

So, to continue. I get to the Norman Fischer link. It takes me to his newsletter where I learned that Norman not only has a new book out: Sailing Home, but he wrote an article in the September 2008 issue of O Magazine (as in Oprah), called "Simple Yet Astounding Ways to Calm Down".

As with everything related to Norman, the article is wise, kind, thoughtful, and easy to read.

Forget about reading anything I have to say about multi-tasking, getting through tough times, yoga & longevity. Read Norman's article! It's all right there.

And by the way, even though Norman advises against giving advice to grown-up kids, in this case I disagree. So, Son #1, Son #2, Daughter-in-law #1, if you are reading this, I know you guys are crazy busy. I hope you have a chance to read Norman! It will serve you well.

"If you're so crazed that you have to pencil in time for a deep breath, here's how to become more relaxed—and efficient—in less than a minute. All together now: Ahhhhh…

You keep a to-do list, but you can't get through it by the end of the day, and you're frustrated because you feel like you haven't been able to get enough done. You find that things take longer than you thought they would. And when people ask how you are, "Fine" has been replaced by "Too busy."

Welcome to the "too busy" club.

In this technology-driven world, we can do more, so we do—and we love it. We feel effective and powerful as we check items off our lists and use our cell phones, BlackBerrys, and computers, sometimes all at once. We're multitasking, doing as much as we can in the least amount of time. We're active, creative, and engaged! In demand! Being too busy makes us feel as though we're making an impact.

On the other hand, feeling too busy drives us crazy. Falling ever further behind as the to-do list relentlessly grows (each item generating many more items almost as fast as we can think of them) is nerve-racking and stressful. We begin to feel like prisoners of the list, prisoners of our lives and our desires, prisoners of time. There just aren't enough hours in the day. It's as if we're doing battle with time—and losing.

But the point is not how many things we have done or will do in a given amount of time; the point is how we do what we do. If we're rushed and frantic, we're too busy. If we move through our tasks with equanimity, patient and composed, we're not.

In the Zen Buddhist tradition that I've been practicing for many years, there's a story that illustrates this point: A monk is sweeping the temple grounds. Another monk comes by and says, "Too busy!" The first monk replies, "You should know there is one who is not too busy."

Our sweeping monk may have been moving quickly, and so he looked "too busy" to his brother monk. But inside—in his mind—he wasn't busy. In the midst of his vigorous activity, he was in touch with "the one who is not busy."

Most of us judge how busy we are by how much we have to do. When there are too many things to do, we think we're busy, and when there isn't much to do, it feels like we're not busy at all. But in fact, we can feel busy when there isn't that much to do, and we can feel relaxed even when there's a lot going on. The states of "busy" and "not busy" aren't defined by how many things there are to do. Contrary to popular opinion, there is no such thing as multitasking; the brain can tend to only one thing at a time. Being too busy or not being busy is an interpretation of our activity. Busy-ness is a state of mind, not a fact. No matter how much or how little we're doing, we're always just doing what we're doing, simply living this one moment of our lives.

That moment may seem long or short. Time is an internal, not external, reality. Have you noticed that half an hour in the dentist's chair lasts longer than half an hour at a fun dinner party with friends? And five minutes waiting on hold on the phone passes more slowly than five minutes watching a movie. Time is how we live it, not what's measured by the clock (after all, the watch was invented fairly recently, in the 16th century). To be sure, our world operates on clock time, which is convenient and necessary; how else would we make it to that dentist's appointment or dinner party? But the clock is supposed to be working for us, not the other way around. If we feel too busy, we've mistaken a feeling for an objective reality and are held captive to that reality. It needn't be that way.

Okay, you say, good theory: We think we're busy, but we're not—we're just doing one thing after another. But the habit of being convinced we're too busy is hard to shake. What can we do about this persistent mania of feeling task- and time-driven? Understanding something differently is only a beginning. To change the way we live, we have to practice what we've come to understand until it becomes a natural part of us, a habit of thought, feeling, and body. There are many simple techniques that can help us with this. Take three conscious breaths (try it now, as you're reading). This will change your mind. Whatever you're feeling will become less compulsive, less driven. There's a measure of detachment and equanimity even after the first breath. You become more present to your surroundings, to the basic awareness of being alive. Try it the next time you're feeling overwhelmed; it doesn't take much time, and it will help you remember "the one who is not busy," the part of you that's always right there, even when it looks or feels like you're too busy.

Walking meditation—intentionally bringing awareness to your body as you move—can lift you out of a busy-ness-induced, semiconscious funk. If you can become conscious of the way you're moving and the sensation of each movement, you'll feel refreshed instead of rushed. I know what you're thinking: "I'm too busy to go for a walk." But this is something you can do on your way to and from the bathroom. (And if you're really feeling busy, you're probably overdue for a trip there anyway.)

Sometimes just a phrase can help: "Not busy." Remembering our two monks, you can say this softly to yourself when you feel overwhelmed. I do this when I feel crazed; with the repetition of the words, I immediately recognize that it is my feelings and my thoughts that make me feel pressured, not the tasks I have to do. They will get done—or not, and the world and I will survive. Even if I do have a crucial deadline, I'll have a much better chance of making it if I feel "not busy" and can proceed with a calm mind. Feeling frantic doesn't make me more efficient. Quite the contrary, it makes mistakes and glitches more likely.

It goes without saying that if you've bitten off more than you can chew in a day, or in a lifetime, you'd better step back and change your circumstances, if at all possible. Let go of a few activities: Peace of mind is more important, and healthier, than those few extra accomplishments. But if you can't or don't want to change your circumstances, you need to find the most serene and beautiful way to live the life you have.

In the end, if you persistently and unpleasantly feel too busy, remember this: It's not a fact; it's a choice. There is one who is not busy. That one is you."

May 07, 2011

An animated depiction of a typical heart attack, from the documentary “Forks Over Knives.”

If you received this via email, click here to get to the web version with all the links and more.

My friend Barbara must have been up very late last night.

Here's the email I found in my in-box early this morning:

"at this moment, the review of "Forks Over Knives" is the most e-mailed article on the NYT."

You can read it yourself, "Soul Food, Vegan Style," by Jeanette Catsoulis. Looks like Catsoulis thought it was too heavy on data & statistics. She was looking for more entertainment. Why, I can't imagine?

I love the Times, but I can't always count on their movie reviewers to lead me in the right direction. This one is no exception. Go see it for yourself!

Check out the LA Times & Variety reviews below.

"One of the more convincing, radical and politically volatile docus to come out of the burgeoning good-food genre, "Forks Over Knives" advocates quite convincingly for the adoption of a plant-based diet, the intent being the eradication of the diabetes, obesity and hypertension afflicting an increasing number of Americans."

Variety, May 5, 2011

'"Forks Over Knives" — eating right over surgery — explains in unflinching detail how we damage ourselves through our eating habits yet insists that it is within our grasp to change course. Many nutritional experts bolster Campbell and Esselstyn's arguments, and patients attest to Esselstyn's life-saving treatments."

L.A. Times, May 5, 2011

Soul Food - Vegan Style - The New York Times Review

"A tale of two doctors, many cows and a multitude of human ailments, Lee Fulkerson’s “Forks Over Knives” makes a pedantic yet persuasive case for banishing meat and dairy from the dinner table."

"While at times fascinating, this trudge through statistics, graphs and grainy film of cholesterol bubbles and arterial plaque may challenge even the most determined viewer."

"Luckily, things pick up midway, as Mr. Fulkerson bites into the global consequences of our food choices and the extent of corporate influence on our official nutrition guidelines."

(my comment) And Catsoulis, just like everyone else who has seen this movie, enjoys hearing Anthony Yen (age 82) explain how switching to a plant-based diet helps men to once again "raise the flag".

Yen became part of Dr. Esselstyn's study at the Cleveland Clinic after quintuple bypass surgery failed to resolve his cardio-vascular disease. He's been eating plant-based since the 1980's--and if the photo below isn't an endorsement for the plant-strong lifestyle, I don't know what is! BTW, Yen is my inspiration for oatmeal with greens.

Best line in the review, was the last--in the parental guidance rating: “Forks Over Knives” is rated PG (Parental guidance suggested). Nasty diseases and scary statistics.

Anthony Yen, one of Dr. Esselstyn's original patients. Here, at age 81, at a Whole Foods/Engine 2 event, May 2010

Adding My Two Cents

Not wanting anyone to miss this must-see documentary, I had to add my comment to the review. Here's what I wrote:

Display Name

The Healthy Librarian

Rating:

Location

U.S.A.

Title

Go See It---It Will Change What You Eat!

Review

I saw the preview a year ago & it changed my way of eating--and my health, forever. Can't imagine going back to cheeseburgers, fries, and greasy pizza.And yes, I still enjoy delicious burgers & pizza--but they're now plant-based & without cheese.

A simple change in food choices real does stop the course of heart disease, obesity, type 2 diabetes, & hypertension. No more pills or procedures needed.

Everyone I personally know who has seen this movie (in preview)--including some cynics, skeptics, & physicians-- was entertained, impressed, had their eyes opened & minds changed.

Friends who went on to make their own diet changes have surprised their physicians with their improved health--in just a few short weeks. And it kept getting better. Diet trumps drugs, hands down.

Read the summary of the movie I wrote when I saw it last year. You'll learn much more than from this NYT's review!

This week Dr. Caldwell Esselstyn, Jr. is speaking at a closed-to-the-public Wellness Grand Rounds. I'll be there--along with some of the other healthy librarians with whom I work. Trust me, we had a hard time finding someone willing to miss his lecture, & stay behind to mind the store.

Dr. Esselstyn will review the epidemiology of coronary artery disease, establishing this is a food borne illness. He will examine the method and result of a lifestyle nutrition change that may halt and reverse coronary artery disease.

Bio: Caldwell Esselstyn, MD, FACS

Twenty-three years ago, while chairman of the Cleveland Clinic's Breast Cancer Task Force, general surgeon Caldwell B. Esseistyn, Jr., M.D., grew disappointed in the way he and his colleagues were treating cancer and heart disease.

Relying on pills and procedures despite their side effects and risks, Dr. Esselstyn says he and his peers were doing "nothing to prevent diseasethe next unsuspecting victim."

This was particularly frustrating given that research studies had already suggested an obvious culprit. The fatty American diet was, in all likelihood, responsibe for heart disease and many Western cancers, which are infrequently seen in parts of the world where much less fat is consumed.

Targeting heart disease, Dr. Esselstyn's experiment started at home. He and his wife adopted a plant-based diet, cutting out oil, meat, fish, fowl and dairy.

"It means a lot to patients to know their doctor is making the same changes they are," he says.

Since studies show a craving for fat diminishes the less fat one eats, and since patients have hundreds of recipes from which to choose, the physician and his heart patients have grown comfortable with their routine, over time.

[N]utrition consultant Kris Napier attributes some of the success of Dr. Esselystyn's research study to the time and personal attention the surgeon devotes to the patients. He met with each patient every other week for the first five years of the study, every month thereafter.

The surgeon, his wife, the patients and their families still gather several times a year for picnics at which they share favorite low-fat, plant-based dishes.

Update - Oops! A Plant-Based Cardiologist Just Told Me About the LA Times & Variety Reviews - I Hit the Publish Button a Moment Too Soon!

The LA Times Capsule Review:

The signal importance of executive producer Brian Wendel and writer-director Lee Fulkerson's richly inspiring and informative documentary "Forks Over Knives" lies in its persuasive presentation of solutions to unhealthful eating habits. The film centers largely on the work of T. Colin Campbell, a professor emeritus of Nutritional Biochemistry at Cornell, and Dr. Caldwell B. Esselstyn, a renowned former surgeon at the esteemed Cleveland Clinic.

Both investigated exhaustively the role of nutrition in health. Campbell co-wrote the monumental "The China Study," a survey of the relationship between nutrition and cancer in Chinese people; Esselstyn wrote among many other publications, "Prevent and Reverse Heart Disease," based on his long-term nutritional research on arresting and reversing artery disease, even in severely ill patients.

The bottom line:

Whole plant foods are beneficial, while animal-based foods are not. Furthermore, whole plant foods prove to be genuinely satisfying, though junk food, which can be so pleasurable to eat, is so lacking in real nourishment that it causes one to crave more of it, which then escalates cholesterol levels and calorie intake.

"Forks Over Knives" — eating right over surgery — explains in unflinching detail how we damage ourselves through our eating habits yet insists that it is within our grasp to change course. Many nutritional experts bolster Campbell and Esselstyn's arguments, and patients attest to Esselstyn's life-saving treatments.

To his credit, Fulkerson, who had been dangerously out of shape, turned his life around in making this most important and heartening documentary.

One of the more convincing, radical and politically volatile docus to come out of the burgeoning good-food genre, "Forks Over Knives" advocates quite convincingly for the adoption of a plant-based diet, the intent being the eradication of the diabetes, obesity and hypertension afflicting an increasing number of Americans. Pic's advocacy for produce and against meat and dairy should make it a lightning rod for the politically corpulent processed-food industry. Whether the film reaches the people it should reach probably depends on getting a well-positioned TV platform following brief theatrical play.

As a narrator, helmer-writer Lee Fulkerson has listened to too much "Dateline," but as a journalist, he covers the food front: From groundbreaking researchers T. Colin Campbell and Caldwell B. Esselstyn Jr. -- doctors who grew up as farmers and eventually rejected the foods of their youth -- to everyday people beset by ailments brought on by fat and processed food. What "Forks" barges into, and other health-advocacy films haven't, is the political clout behind keeping Americans unhealthy. Fulkerson not only addresses this but talks to those responsible, who generally don't make such a good case -- and don't look too healthy, either.

Go See It!

As a friend, who is a cancer survivor told me recently, "I can't control the chemicals or pollutants I'm exposed to, my genes, or what I did or did not do in the past. But, I can control what I choose to eat NOW!"

March 26, 2011

The Waitresses Dress as Nurses at the Heart Attack Grill in Chandler, Arizona

We can, as a society, be astoundingly cruel to people who are obese.

"Maybe this partially explains why obese people are flocking to a restaurant outside Phoenix, Arizona, whose name, and I am not making this up, is the Heart Attack Grill.

The restaurant, which seats 100, is often packed. It offers what owner Jon Basso calls, "an environment of acceptance to overweight customers who are typically demonized by society."

A few weeks ago, the 575-pound spokesman for the Heart Attack Grill, a 29-year-old man named Blair River, died. It wasn't a heart attack, it was pneumonia. He had been the public face of the restaurant and the star of its advertising. He was also the single father for a five-year-old girl.

At nearly 600 pounds. Blair River ate all his meals free at the restaurant.

Heart Attack Grill owner Jon Basso did not deny the link between the young man's excessive weight and his tragically premature death.

"I hired him to promote my food," said Basso, "(but his) life was cut short because he carried extra weight."

Blog reader Kate just sent me a link to Robbins' sensitive essay on obesity. It's a quick read--and it took me by surprise. That's all I'm going to say.

I just got home from work--and I'm about to head out the door, so a link is all you get--but all you need. I just wanted to pass this essay on in case you haven't yet seen it. It certainly touched me. Click here for: Being Fat in America